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Introduction: The prevalence of important public health problems like road traffic accidents (RTA) and depression are surging. This study was aimed to estimate distribution and determine the association between RTA and depression among Indian population aged 45 years and above: overall and stratified into age group, gender and across states/union territories as aspirants, achievers, and front runners. Methods: Using Longitudinal Aging Study in India (LASI) dataset (April 2017–December 2018), we have conducted this study among middle aged (45–59 years) and older adults and elderly (≥ 60 years) Indians. Bivariate analysis was conducted to estimate the prevalence of RTA and depression nationally and across aspirants, achievers, and front runner states. States and union territories were categorised as low, medium, and high as per RTA and depression prevalence, which were further cross tabulated. Spatial distribution maps were created using Microsoft Excel. We have documented the association of RTA with depression. To reduce the confounding effects of demographic and socioeconomic; health related and behavioural covariates; propensity score matching (PSM) was conducted. Nested multilevel regression modelling was analysed using STATA version 17. Results: Prevalence of RTA was 1.84% (1.74–1.94) nationally, highest among achiever states [2.04% (1.82–2.30)]. Prevalence of depression was 6.08% (5.90–6.26) nationally, highest among aspirant states [7.02% (6.74–7.30)]. The adjusted odds of having RTA was significantly among depressed [aOR (95% CI) 1.76 (1.45–2.15)] than non-depressed participants; which was much higher among females [aOR (95% CI) 1.93 (1.43–2.62)] than in males [aOR (95%CI) 1.67 (1.29–2.16)] and much higher among middle aged [aOR (95%CI) 2.08 (1.63–2.65)]. Odds of RTA was highest across front runners [aOR (95%CI) 1.86 (1.26–2.72)] followed by aspirant states [aOR (95%CI) 1.79 (1.37–2.33)]. Conclusion: This study established the positive association between depression and road traffic accidents among middle aged, older adults and elderly. Therefore, efforts must be taken to address mental health issues in them with proper policy implication more focused on females and middle aged. Front runner's states should get the limelight followed by aspirant states. [ABSTRACT FROM AUTHOR]

Ayurveda is a time-tested science that systematically explains its concepts through eight branches. Grahas Chikitsa (Ayurvedic treatment of microbes) is one of these branches, and it is well-explained in the texts. "Graha" refers to a tiny, invisible living organism that may undergo several stages of development and can be pathogenic or antigenic to the body. Microorganisms can cause generalised pathogenic alterations in the body that affect multiple systems, similar to the concept of Grahas. This suggests a deeper understanding of microbes in relation to Grahas. This review paper aims to explore the age-old concept of Balgrahas (microbes) and its relevance in modern times. The review was conducted using published articles on paediatric disorders, electronic databases, textbooks on paediatrics, and traditional Ayurvedic writings related to Kauamarbhritya (Paediatrics). A distinguishing feature of this study is its compilation of information on Balgraha from classical texts, covering clinical characteristics, causal factors, and various internal and external treatments. It also discusses Ayurvedic treatment modalities such as Daiva Vyapashraya Chikitsa (Spiritual therapy) and Yukti Vyapashraya Chikitsa (Rational therapy). In this review, authors discussed several formulations for treating conditions associated with Balgraha (microbes) that have not been detailed in previous studies. Additionally, some Shodhan karma (Detoxification) procedures that are particularly recommended for both children and nursing mothers are also highlighted. [ABSTRACT FROM AUTHOR]

ABSTRACT: Introduction: By scrutinizing the impact of job schedules, workplace culture and stress levels, our study aims to determine the prevalence of sleep disorders among various occupations and its associated factors. The findings promise to enhance the overall well-being, sleep quality and productivity in various occupational settings. Methods: This is an analytical cross-sectional study involving secondary data from the nationally representative Longitudinal Ageing Study in India (LASI Wave I 2017-18) of 35 Indian states and union territories with exception of Sikkim. The study included 59441 Indian volunteers who older than 45 years. Multivariable logistic regression analysis was conducted to study the association of sleep disorders among various occupations while accounting for other associated factors. Results: Prevalence of sleep disorders was higher among the females (12.66%), unemployed (13.34%), ≥ 60-yr age group (13.45%), those who lived in rural areas (12.35%), those who were illiterate (12.80%) and reported themselves to be widowed, separated or divorced (14.54%), people with no health insurance (11.74%), smokers (12.11%), without physical activity (12.67%) and also rated themselves as poor in the self-rated health status (26.77%). Alcohol consumption was not statistically significant factor for sleep disorders. Conclusions: There is an emerging need for targeted screening, prompt detection and early management of insomnia and other sleep disorders among the high-risk groups. Provision of accessible and affordable screening tools, training skills for early diagnosis at primary care level and/or proper referral services to higher centres form the cornerstone for adequate management of sleep disorders. [ABSTRACT FROM AUTHOR]

Aim: To investigate the effects of once‐daily oral semaglutide 50 mg on energy intake, appetite, control of eating and gastric emptying. Methods: A clinical pharmacology, double‐blind study was conducted in 61 adults with obesity randomized to once‐daily oral semaglutide (dose‐escalated to 50 mg) or placebo for 20 weeks. Energy intake was measured during an ad libitum lunch, and participant‐reported appetite ratings and Control of Eating Questionnaire responses were assessed. Gastric emptying was measured using paracetamol absorption following a standardized breakfast. Results: The relative change from baseline in ad libitum energy intake at week 20 (primary endpoint) was −39.2% points (95% confidence interval −59.0%, −19.4%) with semaglutide compared with placebo. Body weight was reduced by 9.8% with semaglutide and by 1.5% with placebo. Semaglutide reduced hunger, increased fullness and satiety, and was associated with fewer food cravings and better control of eating versus placebo. No statistically significant difference in gastric emptying was observed at week 20. Conclusions: In participants with obesity, once‐daily oral semaglutide 50 mg reduced energy intake, body weight and appetite, and improved control of eating. There was no evidence of delayed gastric emptying at week 20, as measured through paracetamol absorption. [ABSTRACT FROM AUTHOR]

This study was conducted to determine the clinico-epidemiological evaluation of chronic folliculitis of the leg in the southern Indian population. This was a prospective observational study, undertaken over a period of two years. All patients attending the outpatient department Southern Indian tertiary care hospital's Dermatology Department (M.K.C.G.Medical College & Hospital, Odisha) were recruited. A total of 100 patients were enrolled, aged between 12 to 70 years with a M: F ratio of 10.1: 1. Eighty per cent of the population in the study were rural, and 20% belonged to the urban area. Clinical characteristics and demographic data of the patients were collected in a pre-designed proforma. Those patients who had pustules on the leg underwent pus culture and sensitivity test. Majority of the patients presented with papules and pustules (96%cases) and bilateral symmetrical leg involvement (98% cases). Pruritus was the most common clinical presentation ( 90% cases). Staphylococcus was isolated in the majority of cases (80%) and was sensitive to Amikacin (73%), Linezolid (70%), vancomycin (68%), and Gentamycin (65%). Chronic folliculitis of the leg is mainly a disease of young adult males of low socioeconomic status. Avoiding aggravating factors and cautious use of sensitive antibiotics may achieve treatment goals and decrease recurrence.

Abstract Background A remarkable decline in fertility rates has been observed in many countries, with a primary determinant being an increase in the use of contraceptives. However, the birth rate in Pakistan is still higher compared to the other countries of the region. Therefore, this study aims to assess the effect of demand- and supply-side factors associated with the use of contraceptive measures in Pakistan. Methods Secondary data analysis of four data series of the Pakistan Demographic and Health Surveys (PDHS 1990–1991, 2006–2007, 2012–2013 and 2017–2018) were used. The data includes ever-married women aged 15–49 years who had given birth in the previous five years and participated in the family planning module of the PDHS. A total of 25,318 women were included in the analysis. Data were analysed by investigating the associations between independent variables (demand- and supply-side factors) and the use of contraceptive measures through unadjusted odds ratios (OR) and adjusted OR (AOR). Results The results among demand-side factors indicated that in 2012–2013, women without media exposure were less likely to use contraceptives and the trend remains almost constant for 2017–2018 (AOR = 0.664, 95% CI 0.562–0.784) in 2012–2013 and (AOR = 0.654, 95% CI 0.483–0.885) in 2017–2018. However, they still show a lower likelihood of using contraceptives without media exposure. The results among supply-side factors indicated that absence of transport (2012–2013) and limited visits by family planning workers over the previous 12 months (2006–2007, 2012–2013 and 2017–2018) remained significant factors for not using contraceptive methods. Conclusions The results of the study indicate that certain demand- and supply-side factors are associated with the use of contraceptive measures in Pakistan. It highlights the need for the provision of family planning resources and further structural factors, particularly in remote areas.

Introduction: The aim of the study was to compare eligible individuals who were or were not treated with bariatric surgery and describe disease burden, treatment, and healthcare costs over 3 years in individuals who were not. Methods: Adults with obesity class II and comorbidities, or obesity class III, were identified in IQVIA Ambulatory EMR – US and PharMetrics® Plus administrative claims databases (January 1, 2007–December 31, 2017). Outcomes included demographics, BMI, comorbidities, and per patient per year (PPPY) healthcare costs. Results: Of 127,536 eligible individuals, 3,962 (3.1%) underwent surgery. The surgery group was younger, a greater proportion were women, and mean BMI and rates of some comorbidities (obstructive sleep apnea, gastroesophageal reflux disease, and depression) were higher than in the nonsurgery group. Mean healthcare costs PPPY in the baseline year were USD 13,981 in the surgery group and USD 12,024 in the nonsurgery group. In the nonsurgery group, incident comorbidities increased during follow-up. Mean total costs increased by 20.5% from baseline to year 3, mostly driven by an increase in pharmacy costs; however, fewer than 2% of these individuals initiated antiobesity medications. Conclusions: Individuals who did not undergo bariatric surgery showed a progressive worsening of health and increasing healthcare costs, indicating a large unmet need for access to clinically indicated obesity treatment.

Objective: The emergence of resistance against last-resort antibiotics, carbapenem and colistin, in Klebsiella pneumoniae has been reported across the globe. Bacteriophage therapy seems to be one of the most promising alternatives. This study aimed to optimize the quantity and frequency of bacteriophage cocktail dosage/s required to eradicate the Klebsiella pneumoniae bacteria in immunocompetent septicemic mice.Methods: The three most active phages ɸKpBHU4, ɸKpBHU7, and ɸKpBHU14 characterized by molecular and TEM analyses were in the form of cocktail and was given intraperitoneally to mice after inducing the septicemia mice model with a constant dose of 8 × 107 colony-forming unit/mouse (CFU/mouse) Klebsiella pneumoniae. After that, the efficacy of the phage cocktail was analyzed at different dosages, that is, in increasing, variable, constant, and repeated dosages. Furthermore, interleukin-6 and endotoxin levels were estimated with variable doses of phage cocktail.Results: We have elucidated that phage therapy is effective against the Klebsiella pneumoniae septicemia mice model and is a promising alternative to antibiotic treatments. Our work delineates that a single dose of phage cocktail with 1 × 105 plaque-forming unit/mouse (PFU/mouse) protects the mice from fatal outcomes at any stage of septicemia. However, a higher phage dosage of 1 × 1012 PFU/mice is fatal when given at the early hours of septicemia, while this high dose is not fatal at the later stages of septicemia. Moreover, multiple repeated dosages are required to eradicate the bacteria from peripheral blood. In addition, the IL-6 levels in the 1 × 105 PFU/mouse group remain lower, but in the 1 × 1012 PFU/mouse group remains high at all points, which were associated with fatal outcomes.Conclusion: Our study showed that the optimized relatively lower and multiple dosages of phage cocktails with the strict monitoring of vitals in clinical settings might cure septicemia caused by MDR bacteria with different severity of infection.

Fourier transform holography overcomes the phase recovery challenge through recording complex field information of the object in an interference pattern recorded at the far field, i.e., Fourier plane. Moreover, this geometry helps to reconstruct the complex field of the object from a single Fourier transform, which is an attractive feature for the numerical reconstruction of the digitally recorded hologram. In this paper, we present a nearly common path experimental design for recording a digital Fourier holographic hologram using a beam displacer, and recover the complex valued objects using the Fourier analysis. The performance of the system is experimentally examined for different objects.

Type 2 diabetes is one of the leading threats to human health in the 21st century. It is a metabolic disorder characterized by a dysregulated glucose metabolism resulting from impaired insulin secretion or insulin resistance. More recently, accumulated epidemiological and animal model studies have confirmed that circadian dysfunction caused by shift work, late meal timing, and sleep loss leads to type 2 diabetes. Circadian rhythms, 24-h endogenous biological oscillations, are a fundamental feature of nearly all organisms and control many physiological and cellular functions. In mammals, light synchronizes brain clocks and feeding is a main stimulus that synchronizes the peripheral clocks in metabolic tissues, such as liver, pancreas, muscles, and adipose tissues. Circadian arrhythmia causes the loss of synchrony of the clocks of these metabolic tissues and leads to an impaired pancreas β-cell metabolism coupled with altered insulin secretion. In addition to these, gut microbes and circadian rhythms are intertwined via metabolic regulation. Omics approaches play a significant role in unraveling how a disrupted circadian metabolism causes type 2 diabetes. In the present review, we emphasize the discoveries of several genes, proteins, and metabolites that contribute to the emergence of type 2 diabetes mellitus (T2D). The implications of these discoveries for comprehending the circadian clock network in T2D may lead to new therapeutic solutions.

Abstract Background Powdery mildew (PM) is an important disease of pea that reduce yield. Ascophyllum nodosum extract (ANE) and chitosan (CHT) are biostimulants used to improve plant health. Efficacy of ANE and CHT was assessed individually and in combination against pea powdery mildew. Results Combined applications of ANE and CHT had a significant inhibitory effect on pathogen development and it reduced disease severity to 35%, as compared to control (90.5%). The combination of ANE and CHT enhanced the activity of plant defense enzymes; phenylalanine ammonia lyases (PAL), peroxidase (PO) and production of reactive oxygen species (ROS) and hydrogen peroxide (H2O2). Further, the treatment increased the expression of a number of plant defense genes in jasmonic acid (JA) signaling pathway such as LOX1 and COI and salicylic acid (SA)-mediated signaling pathway such as NPR1 and PR1. Other genes involved in defense mechanisms like NADPH oxidase and C4H were also upregulated by the combination treatment. Conclusion The combination of ANE and CHT suppresses pea powdery mildew largely by modulating JA and SA-mediated signaling pathways.

A 23-year-old female presented at 28.5 weeks gestation with symptomatic heart failure due to severe mitral stenosis and severe pulmonary arterial hypertension. After multidisciplinary planning, she underwent caesarean delivery with mitral valve replacement 48 h postpartum. Cardio-obstetric teams provide expert coordinated care for complex cardiovascular disease in pregnancy. (Level of Difficulty: Beginner.)